godfather of surgery

Chapter 1192 Even Showing Off Can Get Stuck

Zhang Lin spoke eloquently, and the doctors present all had some thoughts on the matter. They felt that the research institute was better, and if they could go to the research institute, they would definitely be able to make some achievements.

Even someone like Zhang Lin is an expert; they can only do better, that's what everyone thinks.

Previously, Zhang Lin and Xiao Wu didn't have a very good reputation at the hospital. As for Xiao Wu, everyone thought that he was able to get into the research institute because he was Yang Ping's underling from the Municipal People's Hospital. There were plenty of people at Sanbo Hospital who were more capable than him.

Zhang Lin only worked odd jobs for Yang Ping in the early stages, so they didn't actually enter the research institute together.

Both of them were incompetent people who got in through connections; that was the image people had of them in the past.

But to everyone's surprise, when the research institute was first established, no one was willing to go.

The Zhang Lin and Xiao Wu of today are different. From "Hook Surgery" to solving a difficult problem in genetics, they are now genuine experts. Even their manner of speaking is different now; they have the air of experts.

"We did genetic testing in the pediatric ward, and the genetic sequencing came back negative; no pathogenic gene was found," Director Bai answered personally.

Zhang Lin asked, "If we don't find the pathogenic gene, we're facing a very big problem—without finding the pathogenic gene locus, we can't cure the disease with causal medication; we can only treat the symptoms."

Symptomatic treatment refers to addressing the symptoms, while causal treatment addresses the underlying cause.

"Currently, we are maintaining symptomatic treatment, using nonsteroidal anti-inflammatory drugs and phosphates. As for glucocorticoids and tumor necrosis factor-α antagonists, we are not using them for the time being, as we feel it is better to be cautious and we will discuss it further later," Director Bai said very calmly.

If the genetic test is negative, then treatment becomes very difficult because there is no target for a cure.

"Not finding the disease-causing gene does not mean that the disease-causing gene does not exist." Zhang Lin's tone was serious and earnest, like a senior expert giving a carefully considered answer.

The doctors in the room were in an uproar. As expected of someone from a research institute, their insights were indeed different.

"It is entirely possible that she carries a disease-causing gene, but the disease-causing gene is an unknown gene and does not currently exist in the human disease gene database. This gene database is also dynamically updated and is not static. Gene testing simply compares the patient's genes with the information in the gene database to find the disease-causing gene information through comparison."

These words caused another uproar. Zhang Lin's insightful views showed that his thinking was above that of others.

Yang Ping smiled slightly. Xiao Wu and Zhang Lin were of average talent, but Yang Ping had seen their efforts. Although they each had their shortcomings, such as Xiao Wu being glib and Zhang Lin being boastful, they also had a common characteristic: they were not unrealistic and started from small things, doing things that others were unwilling to do. They were not ambitious but down-to-earth and could persevere, ignoring the contempt and ridicule of those around them, and daring to do their own thing.

Before Professor Yang could even make a move, Zhang Lin from the research institute had already taken the discussion of Zhe Zhe's case to a new level.

“I suggest re-analyzing the gene sequencing report, not just going through it using existing diagnostic methods, but re-analyzing the exome sequencing report and conducting a more detailed screening of each mutated site,” Zhang Lin said, holding a microphone.

"If you are worried about the time-consuming manual screening, you can use the artificial intelligence model of Nandu Medical University, which can produce results in a few seconds."

A voice added in the conference room. Everyone looked in the direction of the voice and saw Lu Xiaowu, one of the two henchmen of the research institute. His tone was so calm now, truly worthy of the training he received from the research institute.

Yang Ping nodded slightly in his heart. What they said was actually correct. After experiencing Tong Yongqian's case from beginning to end, they had basically acquired the basic research ideas and methods and had mastered the underlying logic of diagnosis and treatment.

Both Director Bai and Director Tan were taken aback. Director Bai, in particular, was very familiar with Zhang Lin. He used to be a young orthopedic doctor, and now he was quite capable after going to the research institute.

“I just saw the gene sequencing report. It only has the final report, not the complete exome sequencing report. If we really want to figure out the cause of the disease and get targeted treatment, we must find out the cause. This disease definitely has a pathogenic gene, but we just haven’t found it yet. There are loopholes in our methods.” Xiao Wu stood up at this time.

If Zhang Lin and Xiao Wu were performing surgery alone, no one would think they were experts. But if the two of them were on the same stage at the same time, they would definitely be experts, and their surgical skills would far surpass those of any group leader at a top-tier teaching hospital.

Zhang Lin's suggestion was like clearing away the clouds to reveal the sun. Director Bai had originally planned to have a long discussion about this case, but now that Zhang Lin had hit the nail on the head, it seemed there was no need for further discussion.

Director Tan turned to look at Yang Ping, who nodded slightly: "They are right. This patient definitely has the disease-causing gene, but it just hasn't been found using the current standard methods. We will definitely be able to find the disease-causing gene by comparing it one by one. This gene definitely exists, and it is very likely a newly mutated gene. Currently, this gene has not appeared in the gene bank. Everyone should know that all the gene information in the gene bank is manually entered by us, and it will always be outdated."

So Zhang Lin and Xiao Wu were right, they're really amazing. They know so much, and they solved such a difficult case in one go. Professor Yang just agreed with them. The many doctors in the conference room were full of envy for Zhang Lin and Xiao Wu.

Is this the end of the discussion for this case?

"In fact, everyone can make more use of the artificial intelligence model of Nandu Medical University in the future. It can help us in many ways. When you have time, you can attend their training courses to understand its scope of application. For example, in today's case, artificial intelligence can be used to compare one by one to find the mutated gene."

"Actually, it's not difficult to learn. It's just that everyone needs to be aware of the limitations of diagnostic methods when encountering difficult cases. Most diagnostic methods have a limited range of application, just like the measuring tool has a certain range. Some difficult cases have exceeded the range of the diagnostic method."

Zhang Lin and Xiao Wu, holding microphones, spoke one after another with perfect coordination, looking every bit like big shots. Even Director Han was impressed by the two of them.

When the artificial intelligence was first launched by Nandu Medical University, many doctors thought it was unreliable and just a gimmick. Unexpectedly, the research institute applied it to diagnosis.

"Then we'll try it out according to Dr. Zhang's suggestion. Does anyone else have any opinions?" Director Bai asked everyone.

Originally, everyone wanted to discuss the treatment of this case, but no matter how they discussed it, it remained at the level of symptomatic treatment. Dr. Zhang clearly stated that the pathogenic gene could be found and etiological treatment could be carried out, so discussing symptomatic treatment at this point became meaningless.

"No need to wait, we can solve the problem on the spot. We'll also demonstrate how the artificial intelligence model from Nandu Medical University can be used for diagnosis. You guys help them with that," Yang Ping instructed Xiao Wu and Zhang Lin.

They immediately went up to the podium. Zhang Lin was holding a laptop with an AI model app on it.

"Retrieve the detailed exon sequencing report and input it directly into the large model. Let it help us check each one. It will definitely find the mutated gene. In this situation, it's impossible for the pathogenic gene not to exist." Zhang Lin and Xiao Wu explained as they operated the system. Soon, after the report was input, the result came out in about ten seconds: the patient's IL1R1 gene carried a newly discovered mutated fragment.

The doctors present were all surprised. As expected, Zhang Lin and Xiao Wu were right. The diagnostic method was flawed. Since the mutated gene had been found, it was very likely that this gene was the pathogenic gene. It did not exist in the gene bank, so it was natural that the pathogenic gene was not found when performing gene diagnosis.

However, even after the results came out, everyone was completely baffled. Nobody recognized the gene, and besides, which clinician has any knowledge about genes?

At this point, their solid foundation of knowledge once again proved its power. Because Zhang Lin and Xiao Wu had accumulated a wealth of knowledge about genes while working on Tong Yongqian's project, they were able to continue their search along this line of thought.

IL1R1 is interleukin-1R1, and it has its defects.
Interleukin-1R1 is located in the interleukin-1 signaling pathway, which is one of the key pathways for regulating inflammation and immune responses in the body.

Interleukin-1 and its receptor interleukin-1R1 interact to activate immune cells, thereby triggering an inflammatory response. Interleukin-1Ra, encoded by the interleukin-1RN gene, is an antagonist of this pathway, inversely regulating this inflammatory pathway.

Hearing this, many doctors felt their heads were spinning. This was all cutting-edge biochemical knowledge. Even if they had a good grasp of basic biochemistry and could get a perfect score on a test, it wouldn't matter because it involved cutting-edge biochemical knowledge. Which doctor had the energy to learn so much biochemical knowledge?

Zhang Lin and Xiao Wu were able to quickly come up with this idea simply because they had learned a lot about this topic while studying Tong Yongqian's case. They were then able to follow this line of thought and use a one-to-one comparison method to find the mutated gene, and then use some knowledge to confirm that this mutated gene was the disease-causing gene.

In fact, teams in both the United States and China have conducted extensive research on this mutated gene and have proposed treatment methods for it.

The moment to show off had arrived, and the two professors couldn't help but feel excited. This meant that they not only understood the problem in diagnosis, but could also cure the disease, and the sense of accomplishment was overwhelming.

If we liken positive regulatory factors to the driving force of the inflammatory response, then negative factors are the resistance. The balance between driving force and resistance is the normal phenomenon. Now, the driving force is greater than the resistance, and the inflammatory response accelerates wildly, which is why autoimmune diseases are caused.

Zhang Lin and Xiao Wu stood confidently on the podium, taking turns speaking with excellent rhythm, explaining the mechanism of the disease clearly, which aroused the envy and admiration of a group of young doctors.

The experts on the stage nodded frequently, with Director Han, Director Tan, and Director Bai giving satisfied nods.

"Xiao Zhang, Xiao Lu! It seems everyone lacks knowledge in this area. Can you tell everyone whether it's possible to treat the underlying cause and how to treat it?" Director Han prompted Zhang Lin and Xiao Wu.

The hint also has another meaning: be mindful of the time, don't talk for too long. These two kids are clearly a bit too eager to show off and are about to go on and on.

"treat……"

"Yes, this disease is curable, meaning it can be treated by addressing the underlying cause..."

"Yes, it is curable. A medication can be used to help increase resistance to inflammation, reduce the dynamics of inflammation, and restore a new balance..."

"Currently, teams both domestically and internationally have successfully treated this disease..."

"..."

What kind of medicine is it? Everyone was full of anticipation, but Xiao Wu and Zhang Lin were so excited that they forgot the name of the medicine for a moment. The name of the medicine was already difficult to pronounce, and it was not a commonly used medicine, so they couldn't remember it now.

Xiao Wu looked at Zhang Lin, and Zhang Lin looked at Xiao Wu. They both hoped the other would say the name, but neither of them could.

Xiao Wu had a sudden inspiration: "Regarding this new drug, let's consult Professor Yang and let him tell us."

In a moment of desperation, Xiao Wu held the microphone in front of Yang Ping, putting the professor in a very difficult position. If the professor had a narrower knowledge base or a poorer memory, he might have been stumped.

"Case discussion, be concise and get straight to the point, stop beating around the bush," Director Han said, his tone slightly reprimanding towards Zhang Linxiao.

Yang Ping smiled slightly, knowing that the two of them were definitely stuck. They had tried to show off and get ahead, so he said, "The older drugs we can use are cannabidiol, which targets IL-1β, and the newer drugs we can use are levofloxacin. The latter is more effective, but it is still in the experimental stage and we may not be able to obtain it."

Yes, those are the medications. How could I have suddenly forgotten them? If the professor hadn't been there, neither of them would have been able to say it. Next time, we definitely shouldn't have both of them on stage together. If one of them is on stage, at least they can look up some information offstage and then make amends for the one on stage. Even when showing off, they should take turns, not both at the same time.

Just as he finished mentioning the name of the medicine, Yang Ping's phone vibrated. He took it out and saw that it was Dean Xia calling him.

As usual, Dean Xia would usually hang up after a few rings on the phone, as a reminder to check WeChat. Yang Ping checked WeChat and saw that Dean Xia had something urgent to discuss with him.

Yang Ping greeted Director Han, and Dean Xia was already waiting for him at the conference room door.

Watching Yang Ping's departing figure, they were relieved to have just missed their chance to stumble on stage. It was only a minute before the two of them were about to make a mistake.

"Professor Yang, let's go to your office. It's a bit noisy in my office. The leaders in Beijing want to call you and have a chat." Dean Xia said as he walked towards the research institute, and Yang Ping quickly followed.

Dean Xia's office is still in a prefabricated building with poor sound insulation, and there is a construction site right next to it, so it is indeed inconvenient to answer the phone.

"The report you submitted has been reviewed by the higher-ups, and they are very satisfied. Your report listed many bottleneck technologies in the pharmaceutical industry, which must be resolved as soon as possible, otherwise we will be at the mercy of others. For example, adjuvants for vaccines may seem insignificant, but without them, no vaccine can be produced," Dean Xia said as they walked.

"The leader wants to communicate with you directly on the phone and hear your opinions." Dean Xia walked quickly and hurriedly; if Yang Ping hadn't also walked fast, most people wouldn't have been able to keep up with his pace.

PS: This case is from Professor Zhou Qing of Zhejiang University. Professor Zhou's team is the most specialized, in-depth and sophisticated team in China for the research of inflammatory genetic diseases. They have not only clarified the mechanism of this disease, but also invented new drugs. Salute to Professor Zhou and his team!